- Title
- The effect of dietary patterns on maternal morbidity (anaemia and hypertensive disorders of pregnancy) in Ethiopia
- Creator
- Kibret, Kelemu Tilahun
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2021
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Anaemia and hypertensive disorders of pregnancy (HDPs) are significant health problems in pregnant women, accounting for substantial morbidity and poor pregnancy outcomes. Evidence has shown that dietary patterns during pregnancy have an effect on anaemia and HDPs. However, the findings are inconsistent and inconclusive, and most studies have occurred in high-resource settings. Therefore, this thesis aims to assess the effect of dietary patterns on maternal morbidity (anaemia and HDPs) in the resource-limited setting of Ethiopia. This thesis generated evidence using a combination of data sources, including a review of global literature, a detailed secondary analysis of large population-based national data and a regionally-based case-control study. A combination of advanced statistical methods, including systematic review with meta-analysis, spatial analysis, multilevel analysis and propensity score analysis, were employed. The effects of dietary patterns on risks in pregnancy (HDPs, gestational diabetes) and birth (preterm birth and low birth weight) outcomes were assessed through a systematic review with meta-analysis, using literature from across the globe. The effect of dietary patterns on maternal morbidity (anaemia and HDPs) was assessed in the low-resource setting of Ethiopia through a propensity score analysis and applying conditional logistics regression model. The spatial analysis and mixed effect multilevel models were applied to assess the spatial distribution and determinant factors of anaemia among women of reproductive age in Ethiopia. The results of the systematic review suggest that healthy dietary patterns (high intake of fruits, vegetables, wholegrain foods, fish and poultry) have a positive effect on pregnancy outcomes (pre-eclampsia, preterm birth, gestational diabetes). The spatial analysis results showed that the prevalence of anaemia among women in Ethiopia was high and that there were spatial disparities across the country. The results revealed that anaemia is a moderate public health problem among women (> 20%) at the national level and a serious public health problem (> 40%) in five of the 11 regional states, based on World Health Organization criteria. The multilevel analysis demonstrated that sociodemographic factors (low educational status, low wealth index, rural residence and unimproved latrine facilities) and reproductive/biological factors (younger age, pregnancy, breastfeeding, and high gravidity) are associated with the occurrence of anaemia. The effect of dietary patterns on maternal morbidity (anaemia and HDPs) in the low-resource setting of Ethiopia was assessed through case-control studies. The results indicated that having a more diversified food intake is associated with lower odds of anaemia and HDPs. Dietary intake should be included as a core component for the prevention of adverse pregnancy outcomes through strengthening existing antenatal care programs. The prevention of anaemia among women could require context-specific and multifaceted intervention approaches, such as improving the economic and educational status of women or improving the availability of clean water and toilet facilities in limited-resource settings.
- Subject
- dietary patterns; maternal morbidity; anaemia; hypertensive disorders of pregnancy; Ethiopia
- Identifier
- http://hdl.handle.net/1959.13/1423777
- Identifier
- uon:37975
- Rights
- Copyright 2021 Kelemu Tilahun Kibret
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 18 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 458 KB | Adobe Acrobat PDF | View Details Download |